HomeMy WebLinkAboutApplication & PhotosLICATI 1-
ERTIFICATE
OF APPROPRIATENESS
ALTERATIONS, NEW CONSTRUCTION
CITY OF MIAMI
HISTORIC AND
ENVIRONMENTAL
PRESERVATION
BOARD
NAME OF HISTORIC SITE OR HISTO IC DISTRICT
.D/ IADDRESSF j/,LL/
ROPERRTY
OWNER'S NAME
bAN L's)
O ER'S ADDRESS, CITY, ZIP CODE
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APPLICANT'S NAME (IF NOT NER)
OWNER'S TELEPHONE NUMBER (DAYTIME)
33/37
APPLICANT'S TELEPHONE NUMBER (DAYTIME)
APPLICANT'S ADDRESS, CITY, ZIP CODE
APPLICANT'S RELATIONSHIP TO OWNER
DETAILED DESCRIPTION OF PROJECT (USE ADDITIONAL PAGE IF NECESSARY)
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ATTACHMENTS SUBMITTED WITH APPLICATION
❑ PLANS OF PROPOSED PROJECT
Q PHOTOGRAPHS OF PROPERTY
❑ MATERIAL SAMPLES
❑ OTHER
I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT ALL INFORMATION IN THIS APPLICATION AND ITS ATTACHMENTS IS CORRECT.
RE OF PROPERTY
SIG ''TURF OF APPLICA , (IF OTHER THAN OWNER)
DATE
DATE `r2 /0 7
FOR STAFF USE ONLY:
APPLICATION NO.
E STANDARD CA
SPECIAL CA
❑ APPROVED
❑ APPROVED WITH CONDITIONS
❑ DENIED
DATE RECEIVE)
DATE OF FI AL ACTION